Cryoprecipitate Versus Fibrinogen

This lecture offers the following credit types: CME, P.A.C.E.®
 

This presentation will explore the critical role of fibrinogen in hemostasis and the importance of its early replacement in bleeding patients. Participants will learn the recommended clinical thresholds that trigger fibrinogen replacement, based on current guidelines and evidence. The session will review and compare the four main options available for fibrinogen repletion—plasma, cryoprecipitate, INTERCEPT® Fibrinogen Complex, and fibrinogen concentrate—highlighting their composition, dosing, and clinical utility. Finally, the presentation will examine recent clinical trial data supporting the use of fibrinogen concentrate, with a focus on its efficacy, safety, and potential advantages over traditional plasma-derived therapies.

Originally published on November 5, 2025

Lecture Presenter

Melissa Cushing, MD

Melissa Cushing, MD

Professor of Pathology and Laboratory Medicine; Professor of Pathology and Laboratory Medicine in Anesthesiology; Daniel M. Knowles, MD Distinguished Professor in Pathology and Laboratory Medicine
Weill Cornell Medical College, Cornell University
Attending Pathologist
New York-Presbyterian Hospital

Melissa Cushing, MD, is the Daniel M. Knowles, MD Distinguished Professor of Pathology and Laboratory Medicine and professor of Anesthesiology at Weill Cornell Medicine in New York City. She is the executive vice chair for Clinical Affairs in the Department of Pathology and Laboratory Medicine at Weill Cornell Medicine and the division director for Transfusion Medicine and Cellular Therapy at New York-Presbyterian Hospital/Weill Cornell Campus. She is the medical director of the clinical laboratories and the CLIA permit holder at New York-Presbyterian Hospital/Weill Cornell Campus. She attended Duke University in Durham, North Carolina; Georgetown University School of Medicine in Washington, D.C.; Emory University School of Medicine in Atlanta for Clinical Pathology residency training; and John Hopkins School of Medicine in Baltimore for her Transfusion Medicine fellowship. She has published over 150 original research articles, editorials, book chapters, and reviews. Her areas of expertise include the treatment of perioperative bleeding, fibrinogen replacement, patient blood management, laboratory stewardship, viscoelastic testing, and innovation in the clinical laboratories. She is an associate editor of the journal Transfusion and on the editorial board of the British Journal of Anaesthesia.

Objectives

After this presentation, participants will be able to:

  • Explain the rationale for early fibrinogen replacement in bleeding patients
  • Identify the recommended fibrinogen thresholds that guide replacement decisions across various clinical settings
  • Compare and contrast the four primary therapeutic options for fibrinogen replacement, including their indications and formulations
  • Summarize key findings from clinical trials evaluating the efficacy and safety of fibrinogen concentrate

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories